Preparing for systematic tuberculosis screening of children and young people in a low-incidence setting: who should we target?

England is close to losing its status as a low-endemic country for tuberculosis (TB).1 Scotland has seen a similar rise in TB prevalence and seems set to follow England unless urgent action is taken.2 In Scotland, no systematic migrant TB screening programme exists, with screening either opportunistic or not undertaken. We compared, by indication, the rates of positive TB screening in children and young people (CYP) under 18 years in NHS Greater Glasgow and Clyde (NHSGGC) to inform a proposed expansion of our local TB screening programme. NHSGGC is the largest health board in Scotland, with the highest incidence of TB (8.5 cases per 100 000).2 Local guidelines recommend opportunistic testing of new migrants from TB-endemic areas. A nurse-led clinic screens newly arrived accompanied CYP seeking asylum and refugees (CYPSAR-A) within Glasgow City. Unaccompanied CYPSAR (CYPSAR-U) are screened within their looked-after CYP health assessment. TB screening for other indications is undertaken by relevant clinical teams. All CYP TB contacts and CYP with positive screening tests are referred to the paediatric TB clinic for further management.